tbuckley/cabot-search huggingface dataset:
AB1078 SPONDYLOARTHRITIS AND INFLAMMATORY BOWEL DISEASE (IBD): CLINICAL AND PARACLINICAL CHARACTERISTICS
Authors: H. Bara, H. Arabi, F. E. Bennani, A. Mougui, I. El Bouchti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases characterized by enthesis involvement. SpA can be associated with extra-articular manifestations, in particular Inflammatory bowel disease (IBD) <h3>Objectives</h3> The objective of the study is to compare the clinical and paraclinical characteristics of a population of patients with spondyloarthritis (SpA) associated to IBD and patients without IBD. <h3>Methods</h3> Retrospective study conducted in the Rheumatology Department, including patients followed up for SpA for SpA between 2004 and 2021. <h3>Results</h3> Our study involved a population of 333 patients with SpA. he averages age was 40.5 years. Men constituted 54.1%. Smokers represented 13.5% of the cases, diabetics 7.5%, hypertensives 8.4% and 9.9% of patients had IBD. In univariate analysis: patients with SpA with IBD had more uveitis (p=0.001), more stage VI sacroiliitis (p=0.0001), more syndesmophytes p= 0.02) and a more active disease according to the BASDAI (p= 0.011). In multivariate analysis, SpA with IBD was associated with uveitis (OR 3.53) and to a BASDAI higher than 4 (OR 2.7). <h3>Conclusion</h3> In our study, uveitis, stage VI sacroiliitis, and syndesmophytes were more frequent in patients with SpA and IBD, with a more active disease. <h3>Reference</h3> [1]PHAM, Pr Thao, and C. H. U. Sainte-Marguerite. "Maladies inflammatoires articulaires et MICI: quelles thérapeutiques?." <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1128 METHOTREXATE MAINTENANCE THERAPY IN PSORIATIC ARTHRITIS
Authors: E. Hannech, S. Miladi, A. Fazaa, H. Boussaa, M. Yasmine, L. Souabni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The management of psoriatic arthritis (PsA) is currently well codified. Methotrexate (MTX) remains the most frequently used DMARD in first-line treatment of peripheral joint disease. <h3>Objectives</h3> We aimed to identify the rate of therapeutic maintenance of MTX during PsA and to determine the date of first biotherapy. <h3>Methods</h3> We conducted a single-center, retrospective study including PsA patients with peripheral joint involvement. Patient and disease characteristics were recorded. We determined the MTX maintenance rate and tolerance profiles. We recorded data related to the first biotherapy. <h3>Results</h3> Twenty-two women and eleven men were included. The mean age was 52.31±12.98 years [21-78]. The mean disease duration was 10.90±5.91 years [1-21]. PsA had an articular peripheral onset in 68.8% of cases and axial and articular peripheral in 31.3% of patients. Psoriasis was present at diagnosis in 27 patients (81.8%). The mean age at diagnosis was 42.70±13.84 years [19-68]. MTX was initiated for all patients after a mean duration of 3.14±2.58 months [1-12]. It was prescribed orally in 86.7% of patients and intramuscularly in 13.3%. The mean duration of treatment was 7.83±5.90 years [1-21]. The maintenance rate at 1 year was 100%, at 2 years was 83.3%, and at 5 years was 70%. MTX was discontinued in 4 patients for adverse events: 3 cases of digestive intolerance and 1 case of liver toxicity. Biotherapy was prescribed for 10 patients (30.3%): Infliximab (2 cases), Adalimumab (2 cases), and Etanercept (6 cases). The time to prescription of the first biotherapy was 4±1.6 years [3-7]. Biotherapy was indicated but not prescribed in 5 patients (15.2%). Causes of non-prescription were mainly lack of social security coverage. <h3>Conclusion</h3> In our study, MTX was the first-line treatment for patients with PsA. The therapeutic maintenance seems to be good reflecting the effectiveness. However, this maintenance is certainly influenced by the socio-economic factors. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0893 CORRELATIONS BETWEEN CT SCAN, CLINICAL AND RESPIRATORY FUNCTIONAL DATA IN SYSTEMIC SCLEROSIS ASSOCIATED INTERSTITIAL LUNG DISEASE
Authors: H. Abida, Z. Meddeb, C. Abdelkefi, A. El Ouni, S. Toujani, S. Hamzeoui, T. Larbi, K. Bouslama
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The role of computed tomography (CT) in the assessment of pulmonary involvement in systemic sclerosis is witnessing constant updates with the development of scores and tools. <h3>Objectives</h3> The aim of our study was to look for a correlation between CT scan, clinical and respiratory functional data and to evaluate the severity of diffuse infiltrative lung disease using the Goh' score. <h3>Methods</h3> It was a retrospective and descriptive study carried out at the Internal Medicine Department of Mongi Slim Hospital. It included data of patients with SSc with pulmonary involvement. We used the Goh CT score and the modified Goh score (with 6 levels) to assess the severity of lung involvement. <h3>Results</h3> 31 patients were included. The mean age of our patients was 50 years. The predominant elemental lesions on chest CT were ground-glass opacities (78%), septal thickening (77%) and traction bronchiectasis or bronchiolectasis (70%). The most common type of interstitial lung disease was non-specific interstitial pneumonia (65%) followed by usual interstitial pneumonia (23%). The statistical analysis showed associations between clinical, respiratory functional and imaging data. Decreased forced vital capacity was statistically associated with honeycomb (p=0.04) and non-specific interstitial pneumonia (p=0.05). It was also associated with the extent of lesions according to Goh score (p=0.031) and the modified 6-level Goh score (p=0.024). Crackles at the bases of lungs were associated with the degree of the reticulation extent according to the modified Goh score (p=0.022). A statistically significant relationship was also noted between cough and the extent of ground-glass opacities according to the modified Goh score (p=0.022). <h3>Conclusion</h3> Chest CT allows the assessment of the severity of lung involvement in SSc using semi-quantitative CT scores. We have concluded that the modified Goh score correlates better with clinical abnormalities. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0926 LA DISFAGIA EN LA ESCLEROSIS SISTÉMICA SE ASOCIA CON PROBLEMAS NUTRICIONALES Y MALA CALIDAD DE VIDA
Authors: L. Cano Garcia, A. Garcia Studer, F. Ortiz-Márquez, I. Ureña, N. Mena-Vázquez, S. Manrique Arija
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Digestive involvement is one of the most prevalent manifestations of systemic sclerosis (SSc) with great significance for the health and quality of life of patients. <h3>Objectives</h3> To describe the prevalence of dysphagia and the nutritional status of a series of patients with SSc. <h3>Methods</h3> Design: Cross-sectional descriptive study. Participants: consecutive recruitment of patients with SSc (ACR/EULAR 2013 criteria) followed up in our unit. Follow-up of these patients is carried out every 3 to 6 months in consultation and all patients were registered in a database. 90% of the patients accepted and signed the consent, the rest refused due to travel or work difficulties. Variables: The main variable was dysphagia, defined according to the EAT10 questionnaire (positive ≥3). The dysphagia risk factors evaluated were: malnutrition according to the Mini Nutritional Assessment (MNA) (continuous: 0-14, considering 14 better nutritional status), sarcopenia defined according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, prealbumin, polypharmacy (if they take &gt;3 drugs), weight loss of at least 1 kg in the last 3 months, quality of life according to EQ-5D and Steinbrocker functional status. Statistical analysis: descriptive and logistic regression (VD: dysphagia) to identify associated factors. <h3>Results</h3> 52 patients were included, of whom 51 (98.1%) were women, with a mean (SD) age of 60.8 (11.0) years. 32/52 patients (61.5%) had dysphagia (EAT≥3) and 12/52 patients (23.1%) were referred to endocrinology for severe dysphagia (EAT≥20) Table 1. Patients with dysphagia compared with the rest had sarcopenia more frequently (37.5% vs 0.0%; p=0.001), weight loss (65.6% vs 20.0%, p= 0.004) and more polymedicated (87.5% vs 60.0%, p=0.022). Likewise, patients with dysphagia (EAT≥3) had lower values (mean [SD]) of nutrition per MNA screening (11.0 [1.2] vs 13.1 [2.3]; p = 0.001), of EQ5D (0.5 [0.2] vs 0.7 [0.2]; p = 0.004), EVA-EQ5D (48.6 [22.3] vs 62.5 [17.6]; p = 0.023) and in Steinbrocker's functional grade (2.3 [1.0] vs 1.3 [0.6]; p = 0.001). The multivariate analysis identified that MNA screening (0-14) (OR [95% CI], 0.511 [0.317-0.824]; p=0.006) and EQ5D (OR [95% CI], 0.965 [0.932-0.998]; p= 0.036) (R2=0.397) were independently associated with dysphagia (EAT ≥3). <h3>Conclusion</h3> Dysphagia is a common problem in systemic sclerosis and is associated with poorer quality of life and a lower probability of reaching a normal nutritional status. The serious nutritional implications associated with dysphagia must be diagnosed in order to intervene nutritionally in these patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0869 ANTI-NUCLEAR AUTOANTIBODIES IN ANTI-U1RNP POSITIVE SYSTEMIC SCLERODERMA PATIENTS
Authors: S. Dahmani, N. Zhuravleva, T. Smirnova, V. Diomidova
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In patients with systemic scleroderma (SSD) with overproduction of anti-U1ribonucleoprotein, there are features in the clinical picture and course of the disease. <h3>Objectives</h3> The aim of the study is to study the level of major autoantibodies in patients with systemic scleroderma who are positive for anti-U1ribonucleoprotein. <h3>Methods</h3> The study included 55 patients (48 women and 7 men, mean age 41.5±11.5 years), positive for anti-U1ribonucleoprotein and meeting the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2013 classification criteria for systemic scleroderma. Defined autoantibodies (AT): rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (ACCP), anticentromeric antibodies (ACA), antibodies to the nonhistone chromosomal protein Scl-70 (anti-Scl-70), antibodies to RNA polymerase III (anti-RNAP III), antibodies to cytoplasmic antigen (anti-Ro), antibodies to cytoplasmic antigen SS-B (La) associated with RNA polymerase III (anti-La), antibodies against DNA (anti-DNA), antibodies to U1-, U2-, U4-ribonucleoproteins (anti-Sm (Smith)), antibodies to cardiolipin (AKL), anti-synthetase antibodies to cytoplasmic antigen (anti-Jo1). After 2 years of complex therapy, these patients were examined. <h3>Results</h3> In patients of the study group, the clinical picture was dominated by inflammatory lesions of the joints and muscles, and skin manifestations were not very pronounced. Interstitial lung disease was detected in 47% of cases. Intersections with diseases (rheumatoid arthritis, systemic lupus erythematosus) were detected in 23% of cases and a combination with Sjögren's syndrome in 21.3%. Other antibodies were often detected: RF (27%), anti-Ro (31%), anti-DNA (32%), rarely - anti-Sm (13%), ACCP (7%), anti-La (5%), ACA (7%), anti-Scl70 (4%), ACL (3%). Anti-Jo1 and anti-RNAP-III were not detected in any of the patients. In patients with systemic scleroderma, highly positive for anti-U1RNP (more than two upper limits of normal) compared with low positive, RF, anti-Ro, anti-DNA were significantly more common (p=0.00). In dynamics after 2 years, high titers of anti-U1RNP persisted in 65% of patients, while other autoantibodies were detected with the same frequency. In patients with an initially low titer of anti-U1RNP, their disappearance was noted. <h3>Conclusion</h3> In patients with systemic scleroderma and overproduction of anti-U1RNP, inflammatory musculoskeletal manifestations predominate and are often associated with Sjögren's syndrome and overlap syndrome. High positivity for antiU1RNP was accompanied by a persistent increase in the levels of RF, anti-Ro, and anti-DNA. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1342 THE EMERGENCE OF FIBROMYALGIA FOLLOWING ACUTE COVID-19 INFECTION
Authors: E. Savin, A. M Tsur, G. Rosenn, O. Gendelman, D. Buskila, G. Halpert, D. Amital, H. Amital
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The exact pathogenesis of fibromyalgia (FM) syndrome is unclear. However, different infections including hepatitis C virus, Human immunodeficiency virus and Lyme disease have already been implicated with the development of FM after their acute phase<sup>[1]</sup>. Imbalance between pro-inflammatory and anti-inflammatory cytokines has been suggested as a possible mechanism that facilitates the neuropathic pain<sup>[2]</sup>. <h3>Objectives</h3> To investigate the incidence of FM syndrome among convalesced individuals following hospitalization for Acute Coronavirus Disease-2019 (COVID-19) and to identify possible risk factors. <h3>Methods</h3> We performed a cross-sectional study on patients who were discharged after COVID-19 hospitalization from the Sheba Medical Center, Israel, between July 2020 to November 2020. A phone interview was performed consisting of the following questionnaires: the Fibromyalgia Survey Diagnostic Criteria Questionnaire, Sense of Coherence Questionnaire to evaluate resilience, and the Subjective Traumatic Outlook Questionnaire to assess the associated psychological aspects of the trauma. The incidence of post-COVID FM was calculated and regression models were performed to identify predictors. <h3>Results</h3> The study population consisted of 198 eligible patients who completed the phone interview. The median age was 64 (52-72) and 37% were women. The median follow-up was 5.2 months (IQR 4.4-5.8). The incidence of FM was 15% (30 patients) and 87% (172 patients) had at least one FM-related symptom. Female gender was significantly associated with post-COVID FM (OR 3.65, p=0.002). In addition, high median Subjective Traumatic Outlook scores and low median Sense of Coherence scores were both significantly associated with post-COVID FM (OR 1.19, p&lt;0.001 and OR 0.92, p&lt;0.001, respectively). <h3>Conclusion</h3> FM is highly prevalent among COVID-19 convalescent patients. Our finding suggests that a significant subjective traumatic experience and a low resilience are highly associated with post-COVID FM. <h3>References</h3> [1]Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: the possible role of infection and vaccination. Autoimmun Rev. 2008;8: 41-43. https://doi.org/10.1016/j.autrev.2008.07.023 [2]Amital M, Ben-Shabat N, Amital H, Buskila D, Cohen AD, Amital D. COVID-19 associated hospitalization in 571 patients with fibromyalgia—A population-based study. PLoS ONE. 2021:16: e0261772. https://doi.org/10.1371/journal.pone.0261772 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1383 A STUDY ON THE CLINICAL PROFILE OF PATIENTS WITH HYPERMOBILE JOINTS
Authors: V. Viswanath, A. G. Varier, H. Sreekumar, L. Sreekumari Ramachandran
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Hypermobile joints are a common yet under-recognized cause of noninflammatory joint pains. Patients with Hypermobile joints display a range of movement that is considered excessive, considering their age, gender, and ethnic background [1]. Hypermobile joints may be asymptomatic or associated with pain, fatigue, multisystemic complaints, and significant disability. In this study, we look at the clinical profile of patients with hypermobile joints who presented to our clinic. <h3>Objectives</h3> To study the clinical profile of patients with Hypermobile joints. <h3>Methods</h3> This is a prospective observational study. Patients who presented to our clinic (from 2018 to 2022) with musculoskeletal complaints with a Beighton score of 4 without concomitant inflammatory arthritis were selected. Clinical data were collected by doctors/trained nursing professionals using a proforma, and demographic and relevant clinical data were collected and analyzed. <h3>Results</h3> 236 patients were studied(203 females and 33 males).The mean age of patients was 41.6 years (±12.7 SD). The median duration of symptoms was 48 months (1 540 months) Median Beighton score was 7. The mean global VAS was 4(± 2 SD). Associated clinical features were as in Table 1. Criteria for Fibromyalgia(2016 revised criteria) were satisfied by 31% of patients. Total Beighton score showed a negative correlation with age (r= 0.334, p&lt;0.05) <h3>Conclusion</h3> People with joint hypermobility-related disorders present a wide range of symptoms that extend across multiple body sites. Symptomatic hypermobile joints are present across all age groups. In our study, most patients presented with pains, especially in the form of dragging pains and cramps. An increase in joint stiffness with age leads to a decrease in the Beighton score, which should be considered to not miss hypermobility in the elderly. Extraarticular features of hypermobility give a clue to diagnoses of hypermobility in those with low Beighton scores. Often these patients are labeled as having fibromyalgia. In our study, 31% of patients satisfied the criteria for fibromyalgia. Hypermobile Joint Syndrome should be considered in patients presenting with nonspecific noninflammatory pains across multiple body sites in all age groups. <h3>References</h3> [1]Tinkle BT, Levy HP. Symptomatic Joint Hypermobility: The Hypermobile Type of Ehlers Danlos Syndrome and the Hypermobility Spectrum Disorders. Med Clin North Am. 2019 Nov;103(6):1021 1033. Doi: 10.1016/j.mcna.2019.08.002. [2]Simmonds JV, Keer RJ. Hypermobility and the hypermobility syndrome. Man Ther. 2007 Nov;12(4):298 309. Doi: 10.1016/j.math.2007.05.001. Epub 2007 Jul 20. PMID: 17643337. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1588 REFERRAL PATTERN FROM PRIMARY CARE TO IDENTIFY PATIENTS WITH SUSPECTED RHEUMATOID ARTHRITIS: ROOM FOR IMPROVEMENT
Authors: M. Sánchez Lucas, C. Bourgeois Avella, T. Schiaffino, J. Molina Collada, J. Martínez-Barrio, J. Rivera, J. M. Alvaro-Gracia, I. Castrejon
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Primary care physicians (PCPs) acknowledge the importance of early diagnosis and intensive treatment for rheumatoid arthritis (RA) patients, however the non-specific symptoms early in the disease and the long waiting list to access rheumatology clinics result in a challenge for early and adequate referral. <h3>Objectives</h3> To evaluate patterns for referral in an early arthritis clinic with direct access for PCPs and to explore variables that may influence an adequate referral. <h3>Methods</h3> An early arthritis clinic (EAC) with direct access for PCPs in our area was started in January 2022 providing direct access for patients with suspected RA or undifferentiated arthritis. Referral criteria are strictly clinical, based on previous early arthritis clinics, literature review and approved by a PCP committee. Patients can be referred if &gt; 2 swollen joints, duration of symptoms &lt;2 years and no previous diagnosis by a rheumatologist explaining the symptoms. A total of 180 PCPs from 11 primary care centres have direct access to the EAC. The following data was collected: distance between hospital and primary care center, number of PCP per center, and zip codes as a surrogate for patient income. A descriptive analysis of the referral pattern is presented. A multivariate logistic regression model was performed to identify variables associated with an appropriate referral. <h3>Results</h3> From January to October 2022, 140 patients were referred to the EAC, 66.4% female, with a mean age of 54.2 (15.3) years. A total of 38 (27%) patients fulfilled the predefined referral criteria with initial diagnosis of rheumatoid arthritis (15.8%), psoriatic arthritis (7.9%) and undifferentiated arthritis (76.3%). Patients who did not meet the referral criteria were mainly patients with osteoarthritis (36.7%), non-specific arthralgia (15.7%), gout (8.8%) and fibromyalgia (6.9%). Patients in the adequate referral group were younger (50.4 vs 55.6, p= 0.03), but have similar income and were referred from a PCP centre with similar characteristics in term of size and distance from the EAC. In the multivariate logistic regression model age was the only significant explanatory variable for an adequate referral (Table 1). <h3>Conclusion</h3> Only 27% of patients referred to the EAC were adequately referred. PCPs need to enhance clinical skill to detect early RA and discriminate mainly from osteoarthritis and non-specific arthralgias. Younger age was the only variable associated with adequate referral. Strategies with a special focus on PCPs are necessary to promote an early and adequate referral. <h3>Acknowledgements</h3> This work was supported by a grant PI20/00847. IC received partial funding from the Spanish Society of Rheumatology (SER). <h3>Disclosure of Interests</h3> None Declared.
AB1576 PERICORONARY ADIPOSE TISSUE (PCAT) ATTENUATION IS ASSOCIATED WITH INFLAMMATORY RHEUMATIC DISEASES (IMD): A RETROSPECTIVE CROSS-SECTIONAL ANALYSIS
Authors: W. Zhu, V. Goel, A. Antony, N. Nerlekar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> PCAT attenuation is a non-invasive biomarker of coronary inflammation and is a poor prognostic factor in patients with coronary artery disease. <h3>Objectives</h3> To compare the severity of PCAT attenuation amongst patients with inflammatory rheumatic diseases (IMD) compared to patients with non-inflammatory rheumatic diseases (NIMD) in a retrospective cross-sectional study. <h3>Methods</h3> All patients seen in Monash Health rheumatology clinics over a 12-month period were identified. Patient records were cross-referenced with the hospital computed tomography coronary angiography (CTCA) database to identify patients who had undergone CTCAs. IMD patients who had their CTCA prior to their RMD diagnosis were excluded. Age, sex, co-morbidities, diagnoses, height, weight, and medications were extracted from the patient electronic medical records. CTCA variables were extracted (mA, DLP, contrast volume, kV, CACS, CAD-RADS) or calculated (SIS, SSS, PCAT attenuation). <h3>Results</h3> A total of 117 patients were included (105 with IMD and 12 with NIMD). There were no significant differences in age, sex, co-morbidities or cardiovascular medication use between groups. Patients with IMD had a lower BMI and were less likely to be smokers or have dyslipidaemia, but were more likely to have hypertension and diabetes mellitus, these were not statistically significant. The mean (±sd) PCAT was higher in IMD patients [-84.6 (±12.14) vs. -92.0 (±5.01) p&lt;0.001) compared to non-IMD patients. There were no significant differences in any other CTCA outcomes. <h3>Conclusion</h3> PCAT attenuation is associated with IMD in this retrospective single-center cross-sectional study. Data from larger prospective cohorts with healthy comparator controls are needed to assess the significance of these findings. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.